It’s busy, but quiet at Cafe de las Sonrisas. There’s no background music and there’s a mellow ambience in this leafy green courtyard in central Granada, Nicaragua. Beautiful hammocks in many colours are slung around the patio perimeter.

Here comes the waitress. Smiling intently, she waits to write down my order in her notebook. Using the wall diagrams and menu pictures for reference, I sign that I would like a coffee and a piece of cake. She nods indulgently at my attempt to sign “thank you”, responds in kind and takes the menu.

She gestures to the panel pasted to the table, bearing six of most commonly requested items. She points at the one with a picture and single word; azucar. No sugar for me thanks.

With the shakiest grasp of Spanish, it’s not the first time I have resorted to using a form of sign language in Nicaragua. This time though, I am at the first cafe in the Americas, and only the fourth in the world, to be entirely staffed by deaf workers.

Cafe de las Sonrisas, or the Cafe of Smiles, is owned and run by a Spaniard, Antonio Prieto, who has become an accidental champion of people with disabilities in the past decade.

Eight years ago, Prieto moved to Costa Rica to set up a restaurant. But something didn’t quite click with him there and he went over the border to Nicaragua, where he immediately felt more at home.

He says he had no intention of helping anyone at all until a chance meeting decided his fate.

“I was travelling in a small town near Leon, in the north of the country, when I met a 14-year-old boy, Cano, who was deaf. I decided to help him. I had only intended to set up a business here, but I had never seen a latrine before I met Cano and that changed my life.”

Prieto, known here as Tio Antonio, found a sign language teacher for himself who introduced him to other deaf people in the community. Before long, he was friendly with a group of 20 people, with whom he could practise his sign language.

Prieto began to think about the huge challenges facing people with disabilities in Nicaragua.

He wrote to Granada’s 160 main businesses asking each if they would employ one person with a disability. He didn’t get a reply from a single business. Prieto says: “It was then I realised that the only way I could help my friends with disabilities to get jobs was to employ them myself.”

The hammock business came first. But he realised early on that he and his workers were on a steep learning curve: “At the start I was upset because the hammocks were ugly,” he says.

It was very important to Prieto that the hammocks were a quality product in their own right and not simply a charitable endeavour. To drive home the point, none of these hammocks carries a label saying they are made by people with disabilities.

The business started with two employees and, five years on, it is self-sustaining and employing 38. In a studio beside the shop, browsers are invited to watch people do this intricate craftwork. One of the workers, who is blind, recently made a hammock for Pope Francis, prompting a letter of thanks from the Vatican.

Armed with this newfound confidence from the hammock business, Prieto decided to open his cafe. Again, it was a shaky start.

He realised, for example, that even if he put in place elaborate signs and symbols for the customers, many of the staff were not able to write the order down. Deaf people are taught only sign language in Nicaragua and they get little, if any, other education, Prieto says. Now the staff have special order pads which allow them to communicate the selected dishes to the kitchen through pictures.

He’s keen to stress that he does not want the disabilities of the members of his staff to define either the business or themselves. “What we need is real integration. That means you come to the cafe and you forget there are deaf people serving you.”

Prieto says he is only doing what he can here, but the general situation for people with disabilities in Nicaragua is unbelievably difficult.

For example, the paths in most towns are obstacle courses for anyone in a wheelchair with holes, cracks, steps and broken pavement commonplace.

And yet, urban dwellers are relatively well off, Prieto says. “In town it is bad, but in the countryside, conditions are worse.” It is not unusual to see a young person with a disability tied to a tree for the day as their family tries to keep them out of harm’s way, he says.

Prieto has been so deeply affected by the situation facing young people with disabilities in Nicaragua, that he has again been prompted to act. One of those he would like to help is a local boy Winston, who has an intellectual disability and some mobility issues.

Winston spends every day in a tiny pen, similar to that used for farm animals. His family says he doesn’t wear clothes during the day to make it easier for them to sluice out his pen. It’s a difficult situation for Winston and his family. Prieto has set up a foundation to help Winston and other people with disabilities living at home in poor conditions.

Rehabilitation services for deaf people are virtually non-existent, so many of them never learn to speak and so are thought of as “deaf and mute”. Prieto’s working on changing that too.

When he met Cano, he could not speak. But Cano had 10 per cent hearing and now, at 22, can hold a conversation. Like other staff at Cafe de las Sonrises, he now has many reasons to smile.

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